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The scientific cherry orchard

Kate’s stepmom is not the only one who thinks that the FA movement is about “the opposite of science.” I can’t count the number of times we’ve been accused of cherry-picking the studies that agree with us, and rejecting the ones that don’t. And I’ve got one thing to say to that: Well, duh.

Guess what: we all cherry-pick. Scientific research, especially when you move into the “softer” sciences, yields masses of complex, sometimes contradictory information. Studies aren’t always designed well, and they aren’t always completely thought through or even fully finished (did you know physicists refer to PNAS as “Premature News About Science”? I just found this out). And even a beautifully designed study risks running up against a previously unconsidered confounding factor. As my dad always says, it’s fruitless to wait for a “killer study” that clarifies everything in one fell swoop; we achieve clarity, or at least sense, by sifting through the morass of imperfect research using the best tools at our disposal. In other words, we cherry-pick.

As a really exaggerated example, I reject any study that finds evidence for extra-sensory perception. I believe that if you scratch pro-ESP research findings, you’ll find bias and criminally poor methodology. Just because that research exists doesn’t mean that I need to incorporate it into my outlook. Certainly it’s scientifically valid to just do indiscriminately huge amounts of research on whatever is around and hope it gets you closer to the truth — replicating others’ research, using past results to inform new studies, and trying out new models and methods all help with this. (This is actually — sorry to those of you with romanticized ideas — pretty much how science really happens. It’s messy and kind of haphazard.) The brute-force approach comes recommended by Francis Bacon, so that’s a point in its favor, and on the whole I think it works fairly well. But part of what you have to do, in order to avoid drowning in results, is use your existing knowledge to filter and structure your findings. In other words, we cherry-pick.

No real difference, except that the studies I disagree with get much more airtime, analysis, and hyperenthusiastic media commentary. Well, and except that the studies I choose to discredit generally have serious methodological flaws, like assuming that fat is coextensive with overeating and sedentary lifestyle, or failing to take into account the effects of dieting, or failing to control for comorbidities that could cause both obesity and ill health. All studies have flaws, but I think it’s pretty major for someone to hang an argument like “fat is caused by unhealthy behaviors” on a model that assumes all fat people have unhealthy behaviors, or to point to the deadliness of fat without considering that the fat subjects’ history of dieting might be more dangerous than weight alone. And even more importantly, the studies I choose to discredit are generally either conducted or sponsored by groups with a vested interest in the results — anti-obesity crusaders, bariatric surgeons, pharmaceutical companies. Fat is big business, and I find big business-funded research to be less trustworthy.

I certainly don’t think that, if we did have a Killer Study, it would find that it’s on the whole healthier to be fat than thin. I actually don’t think that body size, in and of itself, would turn out to be a health risk. Honestly, here’s what I think it would find: that death is inevitable regardless of your habits; that certain habits contribute to greater quality of life, no matter your size; that the degree to which you engage in these habits matters somewhat, but that you can have too much of a good thing; that these habits are practically worthless if you don’t take pleasure in them and look after your psychological well-being; that the human metabolism is complicated and affected by many factors; and that the existing correlation between fat and ill health, or between fat and poor habits, is explained by an overarching causal relationship between dieting, poor habits, fat, and ill health. (In other words, that people who restrict their eating are more likely to be heavier than they otherwise would be, more likely to be in poorer health, and more likely to have a troubled relationship with food and activity, and moreover that dieting causes these things rather than merely being related.)

That’s just my hypothesis, and it’ll remain a hypothesis, because there is no Killer Study. But it’s as consistent with research data as the hypothesis that eating and inactivity cause fat, that all fat people overeat and are inactive, that being thin is simply a matter of willpower, and that food restriction is the answer. In fact, given recent studies that challenge established hypotheses about fat, it may already be more consistent. And it doesn’t require me to actively ignore any studies — it’s not as though I think that research showing that fat is unhealthy never happened, I just think it failed to consider crucially important factors.

I’m proud to say I engage in educated cherry-picking. I’m only peripherally a scientist, but I know a fair bit about biology, I’ve looked at a reasonable amount of research, and I’ve developed an understanding of the issue that is not only consistent, but allows me to both engage in and promote physical and mental health. Sure, if I focused on those studies that the media promotes, I could come up with a different (and, I believe, less consistent) interpretation that said I was doomed to poor health and early death unless I exercised constantly-increasing vigilance, plus that I was probably secretly a compulsive eater and a liar. But that one doesn’t make sense with my experience, and it doesn’t makes sense with the experiences of people I know. And it doesn’t sound like any way to live.

If you come up with a Killer Study proving beyond a shadow of a doubt that my adipose tissue comes from my constant invisible donut binges and will kill me despite my cholesterol, then please, be my guest. Until then, I’m laughing all the way to the data bank.

83 thoughts on “The scientific cherry orchard”

“did you know scientists refer to PNAS as “Premature News About Science”?”

LOVE this. As a scientist, I ask: what news about science ISN’T premature when it is first published? The nature of our work is to form hypotheses, then attempt to prove them. More often than not, we disprove our own hypotheses; if we’re lucky enough that the data supports our line of thought, some years down the road someone else will come up with yet another idea that turns our work on its metaphorical ear.

The beauty of science is that we DON’T know everything. Nothing in science can answer the big questions with a single unifying answer. That’s what continues to make it exciting.

(Side-rant: I wish the mass-market press would stop writing one-line semi-hysterical “sound bites” that completely butcher the scientific reports to which they refer. It’s disrespectful to the scientists and to the general public. /rant)

I don’t disagree with anything you’ve said about science and fat here, but for me, it’s a simpler matter. If I work very hard to lose weight, the best I can do is going from being 100# overweight to being 80# overweight. All that effort for such a paltry reward tends to make me think that I’m doing the equivalent of trying to bend one of those big garage-door steel-springs back. I might succeed in doing it with a lot of effort, but the minute I should relax even a little bit, I had better make sure my face isn’t in the way because that spring is going to go {BOIEEEENG!} right back to its natural state quickly and forcefully!

And let’s say for the sake of discussion I will indeed have a shorter life because I’m 100# overweight. The fact is that you can’t always have your ideal situation in life. Unwillingness in our society to deal with this practical and existential fact of existence has a lot to do with why Americans are so much more fat-phobic than people in Europe or other places. I admit, shallow as it is, that I would really like to look like Brad Pitt, but sitting around mooning about the fact that it ain’t gonna happen certainly wouldn’t be doing myself any favors, now would it?

Being a scientist and a writer, I am trying to get a handle on public perceptions of science. And one of the most unending beliefs is that science is totally neutral, conducted by unfeeling men in white lab coats.

First of all, I tie-dyed my lab coat at first opportunity.

Second of all, science is NOT neutral and never has been. Of course, it’s the search for “the truth,” as if there is one precise truth and thou shalt believe it. Which sounds a bit like religion to me. I want proof and I want studies, and it helps when you don’t jump to conclusions.

That’s the problem with obesity research: the assumption is that fat is bad. Being in the range determined by your genes (not your jeans) is the healthiest thing for you.

My biochem prof in college had a really thick Polish accent, and when she talked about PNAS, she said it like “penis.” Which at 8:30 am is pretty damn hilarious. And I’ve also heard it referred to as “Probably Not Accepted at Science” And Science knows they want to hire me as a staff writer. They know they do. :)

Carrie, that was actually the beginning of the conversation where I found out about “premature news about science” — my boyfriend was explaining to me why his advisor kept talking about “Pee-NAS.” (Which he was doing on purpose. It had something to do with — hey! — a paper that was submitted and published before it was really finished.)

One more comment and I’m going to bed…
I am a research psychologist. And you are exactly right, you have to do a ton of little studies moving in the vague direction of what you are trying to get at before anyone is going to give you the cash to do that beautiful 15 year longitudinal study with a huge sample size and a diverse population. Meanwhile, you run around talking about your studies’ limitations and pleading for people to interpret your work with caution….and then if the result was sexy at all, people will ignore everything else and run with it. Bleah.

isn’t it more amusing still to know that healthy fat people are excluded from the studies as a whole? a girl-friend of mine was. she was described by the researchers as ‘the healthiest person they’d tested – fat or thin’ and then told her she couldn’t participate in the study. apparently, only unhealthy fat people are worth studying.

and she is – she eats better than i do in nearly every regard. and she does love her evening glass of wine. also, she’s a big fan of beets for some reason i can’t fathom. but if the researchers can cherry-picks their subjects but then use the results to apply to *everybody* – that’s dishonesty. dishonesty that’s not lighting anyone’s fires, evidently.

That reminds me of a friend of mine who is overweight. Her body temparture is almost, in its totally normal state, one degree less than the standard 98.6. She joined Weight Watchers when she was younger and did everything she was supposed to do but still didn’t lose weight. The group-leader of the WW support-group she joined appointed two guardians to spend time with her and make sure she wasn’t cheating. What her guardians found to their surprise that she was in fact eating *less* than the amount of food she was supposed to eat because she honestly felt there was no way she could “eat all that food”. So of course, the group-leader told her she needed to drop out of the group because her situation would “discourage” the other dieters in the group.

This post is pretty much exactly what I’ve been thinking about recently, and what I was endeavoring to explain to my boyfriend and one of my best friends, who, while they believe that the “obesity epidemic” hype is certainly overblown, and that fat people deserve just as many rights and as much dignity as the next person, think that fat is still a fairly good indicator of your lifestyle and habits, and that in general, the fatter you are, the more health problems you’re going to have, because of those bad habits. They do make a point of saying that “there are exceptions to the rule”, so you have to take people on an individual basis, but for big studies, you’re looking at trends, and the trend between obesity and greater health problems is, from everything they’ve seen, too intertwined to ignore.

Awesome post, fj. What annoys me about the first article, and several others I have read, is that even the researchers have trouble accepting their results. There is always a quote about how “surprising” it was, or how this doesn’t mean you should stop trying to lose weight. Quite frankly, to those of us living with being overweight, a lot of these findings sound like common sense.

“did you know scientists refer to PNAS as “Premature News About Science”?”
LOL, I’m a scientist but haven’t heard this before. Actually, in my field (ecology) PNAS is considered a well-respected journal, which publishes many solid, relevant studies; this may not be the case in other fields.

To echo i-geek, the beautiful and exciting thing about science – but also frustrating, especially to non-scientists – is that we don’t know everything, and never will. There are no absolutes, no facts – especially in the “softer” sciences, but even in the “hard” sciences – because at any point someone could come along with a methodologically sound study that contradicts the findings of all previous studies. Certain ideas/mechanisms have been supported by such an overwhelming body of evidence, and never or rarely disproved by methodologically sound studies, that we call them “Laws” or “Theories” (and in science, the word theory means something very different from the colloquial usage, i.e., something so widely supported that it’s virtually assumed to be true). But, as unlikely as it is, tomorrow someone could disprove gravity or evolution.

Because of this nature of the scientific method, there’s really no possibility of the one, ultimate Killer Study that would overwhelmingly prove something, without a doubt, as much as we would like there to be. You could overwhelmingly _disprove_ something, but never _prove_ something without a doubt. An extensive and well-designed study could, though, provide very strong support.

A perhaps even more useful study at this point would be a metaanalysis. A metaanlysis involves extracting raw or summary data from numerous studies, controlling for variations in study methodology, and calculating comparable effect sizes to detect the overall trends. There are an incredible number of studies out there already providing hundreds – probably thousands – of datapoints. If someone could cobble together some time and funding, they would certainly produce some interesting results. In the meantime, we’ll just have to keep taking into consideration the roles of funding bias, study methodology, and common sense when “cherry-picking” which studies to cite.

Forgive me if this is a bit off-topic, but I think it fits into the general discussion.

Yesterday, a friend of my mother sent me a link to an online resource on thyroid disorders. There was a big push for “The Thyroid Diet” which is suppose to help hypothyroid sufferers lose weight.

I have hyperthyroidism (a/k/a Graves disease). In the height of my illness I was going to the bathroom too many times a day to count, to the point of coming dangerously near experiencing anal incontenence (I’m sorry about TMI here). Indeed, my inability to sleep was because I just could stop going to the bathroom long enough to get any sleep. I was constantly sweating and my sitting heart rate was about 120 beats per minute.

So I looked around the forum for something, anything I could find on advice for hyperthyroid sufferers regarding slowing the metabolism when your body is literally burning itself alive. Nothing. I looked on the web, for something, anything on the issue of metabolic slowdown techniques for us. Nothing.

The only info I could get was on weight loss for GD sufferers after we get treatment and experience WEIGHT GAIN from our treatment. They will help us learn how to take it off. Ain’t that great? And really, I think this is symbolic of how destructive this “thin is in” mentality has become to the state of our health. Because I take the message away from this that weight loss and metabolic increase is always good, always desirable, and always healthy, no matter how it’s being achieved (or how it’s destroying your health). But if you experience metabolic slowdown, you must try everything possible to speed it up, lest you get fat, which is always bad, always undesirable, always unhealthy, regardless of what’s going on with your body that’s put the weight on you.

Also, the author of this site recommends that the ideal rule of weight is that you allow 100 lbs for the first 5′ of height and 5 lbs for each additional inch. Which is a formula that would leave a woman of my height underweight, and doesn’t allow for a lot of muscle mass no matter what your height. But this is suppose to be about getting those of us with thyroid disorders healthier! Right now, I’m mulling over how to respond to my mother’s friend, who is a nurse, since I know she was only trying to be helpful. But I would like to get into the stuff I find highly problematic about the person she’s recommending since I think it’s kind of important not to let this pass without comment.

I’m a member of the much-malighned media, and I’d like to introduce you to MY whipping boy: The second-tier info-tainment morning news magazine show.

I produce a weekly section on wellness at a newspaper. I find that there are, in fact, good medical reporters producing good journalism on EARLY studies and longitudinal studies. I see routine, dry reports on the wire services by science wonks who DO mention the number of people studied, with good descriptions of of control group and variable group procedures. They always report that we’re considering initial findings — if it’s an early study — or they report incremental findings along with the present. I also happily note that the funders are identified. And it is never, ever presented as conclusive.

Then, a week later, the Today Show or (oh, gawd) Mike & Juliet take the same report and reduce it to a cause-effect soundbite that almost always involves some blonde with a fat-free frame selling a stability ball. They always say: “Now, we KNOW that carbohydrates aren’t metabolized at ALL but are jammed into the fat fold on your abdomen. And if you do 50 crunches on a stability ball while avoiding WHITE FOOD you’ll look just like me.”

Meanwhile, I want to know why healdines aren’t screaming about our real national pastime (sorry, MeMe Roth, it ain’t obesity): overwork and sleep deprivation. There are a number of insitutions (and some Big Pharma folks) finding that we don’t get enough rest (sleep or downtime) and how that is related to pathologies.

Totally agreed, Cindy — the culprit for “media misrepresentation” isn’t the science journalists, and I feel bad when they take the brunt. It’s the furor for sexy soundbites. Not always from the morning shows — often from perfectly good papers and wire services — but you are going to be forced to get that pithy misleading headline and that quote from Papa Willett even if you do your best to be even-handed on treatment of the item. And you’re not going to get to write the item in the first place if it isn’t getting any attention, like dull dishwater HAES.

The other thing about “cherry-picking” is that the term is most ofen used when someone picks out one or two studies that run counter to the vast majority of studies out there on the subject. In this case. there seem to be equal numbers of studies on either side. That indicates that the matter is by no means settled, and so taking the side that agrees with FA is not cherrypicking, it’s making an informed opinion. When you add in the context that a lot of the studies on the other side are funded by biased agencies, that makes agreeing with these studies even less an example of cherrypicking.

Well said FJ, that cherry picking thing is a joke, are we supposed to eat all science like they think we eat all food?

I’ll see your {BOIEEEENG!} LoveandLight and raise you depression! Whenever I try to deliberately losew weight, something in my brain goes THUNK! like an elevator (as you say) hitting the basement. What are we supposed to do?

As someone who *does* have hypothyroidism, looking at the Thyroid Diet stuff on about.com made me deeply skeptical. I did their crazy math, and it come out that I have to eat nearly 3000 calories a day to maintain my weight. Fewer than that, and I’ll lose weight (like magic!). I don’t generally eat anything resembling that many calories a day (I used to do food journaling). I’m still fat. While the plural of “anecdote” is not “data”, I suspect that they’re full of crap.

I’ve noticed a lot recently that many articles suggest things like “we all need to lose weight”. To which I say, “We do? Even my recovering anorexic best friend? My three-year-old cousin? My skinny brother?” Finding information on gaining weight outside of bodybuilding is next to impossible, while info on weight loss nearly clocks you over the head, whatever your weight may be. It’s creepy.

A local opera director where I live told me that “losing a little weight is something most of us probably ought to do.” This was after a story about how difficult trained, talented young singers find the market once they come out of the conservatory. A clinician with the Houston Grand Opera led a master class with grad students in the opera program, and students say she held up headshots of the heavier singers and said: Who can tell me what’s wrong with this picture.

Sad thing is, three of the fatties she was making an example of were finalists in a major Metro opera contest. The judges (including Placido Domingo) didn’t have a problem with the singers’ heft.

Meanwhile, I want to know why healdines aren’t screaming about our real national pastime (sorry, MeMe Roth, it ain’t obesity): overwork and sleep deprivation. There are a number of insitutions (and some Big Pharma folks) finding that we don’t get enough rest (sleep or downtime) and how that is related to pathologies.

But that’s a “noble” thing. Working too much and sleeping to little shows our “dedication,” “strength,” and “commitment.” That’s why no one talks about it. Because, to get all socialist sounding, the big machine would much rather we hear stories about how sick days when you’re sick are almost unnecessarry (I’ve heard it recommended that for a more serious, but still common illness [like the flu] that you stay out of work only until you are past the point of contaigen, not until you feel better), and so-called mental-health days are practically a sin against God. This way you can keep making money for someone, because even decreased productivity is better than none at all. And then once you’re sick and exhausted from treating your body like crap, you can buy whatever the cure-du-jour is to fix everything.

*takes deep breath*

Seriously, I think this is something that is so important, but I don’t think we should ever imagine it will change. Too many people make money off of this, and being tired or wanting a day off or (heaven forbid) a vacation is seen as the same kind of moral failing as fat.

But that’s a “noble” thing. Working too much and sleeping to little shows our “dedication,” “strength,” and “commitment.”

I was forced to read Max Weber’s The Protestant Ethic and the Spirit of Capitalism this last semester. It was pretty dull, but I suddenly feel like I understand why we all work so much and rest so little.

Just to clarify what I saw as the connection here is that if the science of weight loss and metabolism is constantly cherry picked to come up with the “correct” position that weight loss is always achievable and desirable another unfortunate side effect of this is that those of us suffering from a dangerously fast metabolism are related to as downright lucky or at least given no advice on how to slow down our systems. And those who are experiencing a very slow metabolsim due to illness, be it hypothyroidism or anything else, are told to fight that particular aspect of the illness with all their might because the most important measure of health becomes how thin you are or aren’t. Often this comes at the expense of our nutritional needs, which are particularly hard to figure out when there’s something off with your hormones and immune system.

This is a big part of what I find so dangerous about this type of cherry-picking of certain data to support the “pro-thin” posistion is that it doesn’t allow for human complexities, such as metabolic illnesses, to inform the debate at all. It all comes down to, if you’re losing weight, that’s good; if you’re gaining weight, that’s bad. Science, shimence, it’s a lousy public health policy.

You know, I wonder if it’ll stay that way if they publicize this apparent connection between fat and lack of sleep. (And it seems plausible that there would be a connection between fat and stress as well, given that an overproduction of cortisol leads to weight gain!)

Can we take the teeth out of the Protestant Work Ethic by associating it with the Obesity Epidemic? Because for that one, I would allow my fat to be stigmatized with pride.

Can we take the teeth out of the Protestant Work Ethic by associating it with the Obesity Epidemic? Because for that one, I would allow my fat to be stigmatized with pride.

Excellent question fillyjonk (and excellent post in general by the way)…I too would be interested in seeing how that worked. Fat is so heavily associated with lazy that I wonder if anyone would believe it (studies or no studies) if we tried to associate fat with overworked.

PHOEBE: Ok, Ross, could you just open your mind like this much, ok? Wasn’t there a time when the brightest minds in the world believed that the world was flat? And, up until like what, 50 years ago, you all thought the atom was the smallest thing, until you split it open, and this like, whole mess of crap
came out. Now, are you telling me that you are so unbelievably arrogant that you can’t admit that there’s a teeny tiny possibility that you could be wrong about this?

Hopefully teh science will not be so reluctant to change its way of thinking when they realize that it’s the fact we are meant to die that kills us, not teh fat.

That reminds me of a friend of mine who is overweight. Her body temparture is almost, in its totally normal state, one degree less than the standard 98.6. She joined Weight Watchers when she was younger and did everything she was supposed to do but still didn’t lose weight. The group-leader of the WW support-group she joined appointed two guardians to spend time with her and make sure she wasn’t cheating. What her guardians found to their surprise that she was in fact eating *less* than the amount of food she was supposed to eat because she honestly felt there was no way she could “eat all that food”. So of course, the group-leader told her she needed to drop out of the group because her situation would “discourage” the other dieters in the group.

SPROINGGGGG. (‘Scuse me, I gotta go scrape my eyeballs off the wall now.) Now I really HAVE seen everything.

So, we really get to weasel out of WW by having a lower body temperature? Mine is about 97.

i just bankrupted my sanity watchers points for the year at work today and screamed out my frustration on my blog and watched some monty python, but THIS is what has managed to restore my points allowance to pre-today levels.

YOU have allowed me to live another day in this backwards world of ours! thank you! you rule!

You forgot one: infectobesity. The underlying science claims that infection of progenitor cells with certain viruses, particularly adenoviruses, can cause these stem cells to develop into adipose cells. Without the virus, these cells would not follow this path of differentiation.

I actually was just waxing philosophical today (quoting Socrates!), talking about how awesome I think it is that science hasn’t explained everything, and that the massive volume of what science has discovered pales in comparison to the possibly incomprehensible dimensions of what science has yet to tackle.

When the facts aren’t definitive….everybody draws their own conclusion based on what makes the most sense on an individual basis. You know, ideally.

My sanitywatchers points needed this to. I don’t know why I feel the need to *almost* get over myself and my issues and then go read “health blogs.” It’s like picking a scab.

Yes, we do cherry pick. I don’t talk to people about studies that show the conventional “wisdom.” People already take it as gospel. One thing I do and notice a lot of people here do as well tends to be actually looking at the source study or at the very least the abstract. Do people who see a study saying “fat causes cancer” go and see how valid the conclusion was? No, because they assume people will agree with them. When I see that being overweight leads to a longer life span, I see why. Whether or not the conclusion is something I agree with, I stop to think about if there is a causal relationship and which way it goes. I see how big the study was and what the variables and r squared and p value were. I see what they were looking for and how they judged whether or not they found it.

Most people reading the latest penis studies don’t bother. But I do, because I know that should the topic of conversation come up, I am sure as hell going to have to explain and defend myself.

One note on the body temperature thing though. I run really cold and have an unusually fast metabolism. Which, who cares about me, right? But I want to point out that it’s an oversimplification since for awhile I felt very guilty about eating so much and being hungry so often because, really, I run 97 degrees, there’s no way my body needs so much. So, yeah, everyone really is different and healthy habits are healthy habits if they make you feel good.

Wow. I have a low normal body temperature, and I know, because I charted it for weeks and weeks when I was trying to get pregnant; I never broke 98 except during that ovulation spike. I never once connected that with possibly having a slower metabolism, and I’m a biologist! Duh.

Loveandlight, AMEN to your whole first comment, and I too am shocked (even though familiar with WW shenanigans and refusal to believe that cough drops or green peppers aren’t causing someone to stay fat) by what happened to your friend. Gah.

And Cindy, thank you so much for raising the point about overwork and lack of sleep, which I have not looked at scientific evidence on, but have a feeling is a much more important factor in wellness than most of us are willing to admit.

I have ranted about this before but I’m never one to shy away from tiresome repetition, so I will make the point that no excuse–illness, kids, job(s)–is considered good enough to excuse you from exercising without fail. But when people are told to get more sleep they just sort of half-ass it and go “We-e-e-ll, I actually kind of like working a 60-hour week, and anyway I have no choice, and I have to do a 2-hour workout and be at the kids’ beck and call after work, and what are you going to do? Tee-hee!” as they secretly bask in the martyrdom points they’re getting. (Note, I realize some people really don’t have a choice.) They would never “accept” that kind of reasoning if it came to workouts or healthy home cooking.

I was once reading a roundup of “confessions” from health care professionals in a women’s magazine, and one doctor was quoted (when asked what “secret” or quirk she had related to health) as saying that she never missed a workout, never mind if she had to fit it in at midnight. And this was supposed to be more along the lines of a “guilty little secret,” like one other doctor said from time to time he would treat himself to movie popcorn and M&Ms. Sometimes I feel like nobody other than me would look at that quotation and think “Dude, that’s fucked up and you seem to have some kind of issue with exercise compulsion.” More likely they would read it and feel bad about themselves for not having that kind of dedication. But do you think little miss midnight exercise is getting her 7-9 hours a night? I doubt it.

So anyway, Cindy, it makes me feel better that you as a person in the media industry also see this as a problem. I wish more people in a position to spread the information would recognize that this is a potentially serious health issue that is not getting any better.

no excuse–illness, kids, job(s)–is considered good enough to excuse you from exercising without fail. But when people are told to get more sleep they just sort of half-ass it

And indeed, a common response to: “I don’t have time to excercise” is: “Get up an hour earlier”. Which, just… no. If I don’t get my 8-9 hours of sleep a night I am not mentally, physically, or emotionally healthy. Sleep is so important to health!

Therefore Bill Clinton gets to run around scaring schoolkids with the idea that his modest spare tire gave him a heart attack and that they’d all drop dead last week if they don’t get thin, while glossing over his lifelong tendency to short himself on sleep because, you know, all high achievers are short sleepers so he just HAD to do it. (Not to mention also glossing over his genetics, but, separate rant.)

I just want to thank FJ for the links in this post. I read most of them, but ones that made me have an epiphany moment were the starvation study & the study about genetically having a certain weight. I just realized I’ve been starving myself for years partly out of body image issues but mostly out of control issues & fear from having grown up in an abusive environment. Today I actually ate filling meals of good, nutrient-rich food, which at the time felt like I was “overeating” but now that I look back, it was a normal amount of food one would need to fuel a body & mind. It’s a strange feeling having this much energy & a greater degree of mental clarity; I haven’t in so long.

I also feel a lot less neurotic about the weight I’ve gained over winter knowing it’s a natural reaction to having unknowingly starved myself for so long. I’ve only been reading this blog for a couple days but I’ve done a lot of back-reading of previous posts & I just wanted to give y’all my kudos for being awesome.

Oh Meowser and Kate, genetics and stress don’t cause heart problems. Fat, and only fat, causes heart problems. I know this for a fact because this one fat guy totally died of a heart attack this one time. Don’t try to pretend this is not the truth.

Also, this means that if you are fat, and you die of heart problems, you really died of obesity, and I get to count you as an “obesity-related” death and then use that as proof that obesity kills. I will then cite my ground-breaking work showing that obesity kills in my proposal for a study exploring the link between obesity and heart problems.

Count me in with the 97F club. Having a fever’s a bitch, because no one ever believes you could possibly feel like crap when your temperature is only 99 degrees. Yah, been told I’m not sick plenty of times with that nonsense.

And yet, despite the heart palpitations and low temperature and PCOS and infertility and sudden weight gain at the drop of a hat despite no change in diet, I test ‘normal’ in all the thyroid tests I’ve ever had. So, I don’t know what to think any more besides ‘this is normal for me’.

For what it’s worth, I’ve also never believed in the ‘set point’ theory of metabolism, either. If this were the case, then according to the current theories, the amount of exercise I’ve done in my lifetime should have me more than 150lbs less than I weight now. Here’s the thing, though – I don’t gain muscle when I work out. If I have a slow metabolism, muscle should be the #1 thing I gain with any kind of exercise, and it just doesn’t happen.

Anyway, didn’t mean to hijack comments, there, just had to get that off my rack of doom. Also, fj rocks.

I’m a biochemist and I’ve worked in the pharma industry for 10 years and I can say from my observations that all studies have a degree of bias when reported. Surprise, surprise, it’s the money and bottom line. No company wants to hear that their drug product is a failure. In fact, I do quality control, and if something doesn’t work, they are more likely to blame anything else *except* the product.

I run really cold and have an unusually fast metabolism. Which, who cares about me, right? But I want to point out that it’s an oversimplification since for awhile I felt very guilty about eating so much and being hungry so often because, really, I run 97 degrees, there’s no way my body needs so much.

Entangled, yeah, I actually have no idea how the connection between temperature and metabolism works, except for vague memories from the doctor who tested my metabolism when I was a teenager. Not a surprise to find that it runs in reverse in at least one person, because hey — metabolism is complicated and individual! It does make sense that a body producing more heat is using more energy — or would it be that a person with a slow metabolism has less to spare for thermoregulation? — but go figure it wouldn’t be simple or straightforward.

Maybe one of our doctors or nutritionists knows something. I gave it a quick google but found more crap about increasing your metabolism for weight loss through cooking yourself or giving yourself hypothermia or some shit than I’m willing to put up with at a quarter to midnight.

Count me in with the 97F club. Having a fever’s a bitch, because no one ever believes you could possibly feel like crap when your temperature is only 99 degrees. Yah, been told I’m not sick plenty of times with that nonsense.
OMG yes! I, too, am in the 97F (or, usually, lower) club. I’ve actually had a doctor tell me that there’s no way I could have pneumonia, because no one can have pneumonia with a temp of less than 100 degrees. Well, guess what, I did.

I suppose the point I’d like to make about the “cherrypicking” accusation is that many of the things referenced in the Fatosphere are actually meta-analyses, like what Sandy does at JFS, where the nuts and bolts of a study that allegely supports “OMG OBESITY KILLS” are pulled apart and examined for validity. Meta-analyzing studies and saying “this study is flawed in its methodology, and it draws weak and spurious conclusinos from poor data sets, and it received funding from an agenda invested in the weight-loss industry” is not cherry-picking, unless there are perfectly valid, solid studies that are exluded from such meta-analysis because they are so sound that they cannot be challeneged.

You make my insomnia more fun. But seriously: I’m sleeping my ass off after I get home from school. I have fitness class in the morning too! Ha! :P

Being a part of the movement has really opened my eyes with these articles, studies, and so forth that are being released.

I think the comment about us in the movement being more critical of what we hear is accurate. I have some scientific knowledge too, but before, I was never really weary of the difference between journals, studies, articles, experiments, surveys, and the variety of scientific mediums that can be presented (Not to mention the potential for corruption). I like that I’ve been learning a lot about this from all of these experiences.

I also agree with your general “No better: No worse” concept. I think my approach is a little different though. I might go with what I have (Let’s just say I’m armed with the studies you just cited versus everyone else), but other times I will try to compare x and y (Whatever they may be) by their strengths and weaknesses, hoping to find some conclusion that makes them neutral. I started getting into Size Acceptance with the notion that being fat isn’t necessarily unhealthy, unattractive, and so forth, but to sum up what I have now:
“No bodytype is synonymous with health and well being. The means by which you get there might be the road to determining your health. Every bodytype has strengths and weaknesses.”

(And as two of the studies You and Kate have cited say [Well… A conclusion you can get from them if you will): “Shaming teh fatties/skinnies doesn’t FUCKING help!”)

It’s like this game I’m playing right (Onimusha: Dawn of Dreams) now. The five characters have about 20-30 different weapons to choose from, which all have different elements, attack styles, benefits, and some even take things from you or compensate (i.e. Lower defense, higher attack). The same thing goes with the equipment. I have all of this variety, so it makes sense that I change things up, lest my time in the game be either short-lived, boring, pain-staking, or all three.
Thanks for the post fillyjonk. :D

I’ve noticed that as well Elusis. Maybe because of the large number of things against us. I agree that is a non-biased approach, and it does help with everything.

I heard recently that Glenn Gaessar’s book “Big Fat Lies” has almost every study on t3h obesity for the forty years up to its publishing. Does anyone know if his book has a great deal of meta analysis, and if that’s true? Before that, I heard something along the lines of “Gaessar using epidemiological studies against them.” I need a copy. lol

loveandlight, yesterday @ 6:11 pm: This is very interesting, because my normal temperature is around 97.8. If I have a fever of 99, I feel like hell, more so than someone with a regular 98.6 temperature does.

I can’t tell you how many times I’ve had a temperature taken by a doctor only to find him chalk up the low temperature to a malfunctioning thermometer.

I am 100% on board with the notion that overwork/lack of sleep/stress is the real cause of the obesity epidemic in this country. The overwork/lack of sleep factor is pretty much self-explanatory. When you’re tired, you tend to consume more caffeine and sweets just to stay awake. But the stress factor is huge. Of course you’ll never, ever get science to investigate this. Why, when you can just tell people they’re lazy and legitimize hating them?

The problem I have with much of the “obesity epidemic” research is the obvious confirmation bias. The whole premise of most studies seems to be to reinforce an existing thesis and to explain away anomalies rather than to question the dominant paradigm. When the researchers get results that contradict the fat is always evil thesis, they either try to rationalize them or kind of shove them into an “ignore this aberrant data; it’s not important” closet.

Slightly off topic, but did anyone see the Nova special a few nights ago on preparing ordinary, non-athletic folks to run the Boston Marathon? One woman who would be considered “healthy” using the BMI (she was right where she was supposed to be as far as weight for her height went) turned out to be “morbidly obese” when they did a full body density scan — her body was (IIRC) 45% fat.

Hi, this is only the third time I commented on your great site. I’m temporarily living in the US, but I’m trying to start some body acceptance awareness in Brazil. I’m using my blog (www.escrevalolaescreva.blogspot.com) to do that
(it deals with film criticism more than anything else, but because it’s a blog, I have a lot of space to publish any post I want). So far I’ve written two articles on prejudice against fat people. One question I can’t yet answer very well is: how come people in countries like France are overall much thinner than Americans? I mean, I can understand about Asians in general. Could you please help me with that? What are the articles or posts I should read in order to answer that question? Thanks!

“the author of this site recommends that the ideal rule of weight is that you allow 100 lbs for the first 5′ of height and 5 lbs for each additional inch.

Say what? I haven’t weighed 115lbs since I was 14 years old. I didn’t even grow proper breasts till I was 17! Where do these people get these totally arbitrary figures? 1970s diet books?

My late stepfather was as skinny as a rake all his life and a home-brewed beer-loving alcoholic to boot. My mum couldn’t even share a bed with him, (for sleeping purposes), because his body blasted out heat like a furnace regardless of the season. Sounds like his thyroid was over active with bells on though I remember some talk of “brown fat cells”. Does that jog any scientific memories, anyone?

Ooh. Sometime when I can get them together with the kids out of the way for the evening, I have to have a good long discussion with my niece and her husband – who is a diabetes researcher. (He’s also a large chap himself, but generally doesn’t get flak for it because he plays a lot of rugby.)

I really want to ask him, in depth, about the cortisol connection. Stress equals raised cortisol; cortisol overproduction over a long period leads to raised blood sugar and insulin resistance (as well as abdominal fat deposition); end result, someone who’s far more suspectible to Type II. (If someone better versed in biochemistry than me is here, please correct me if that’s wrong or oversimplified.)

I’ve seen passing references to studies that show these connections, but I think I know why they rarely get publicized. One, the whole ‘stress is good for you!’ culture we live in. And two…being ostracized, insulted and treated like a second-class citizen is pretty damn stressful. IOW, treating fat people badly is proven to damage their health in a way that the fat itself probably hasn’t been proven to – as if we didn’t know that.

Diabetes Guy has blithely said ‘oh, it’s because of obesity’ so many times that I really want to have some hard, informed discussion on this. I’m afraid that at some point I may blurt out ‘So…who’s paying you?’. Because whenever I hear of any new study these days, that’s my first thought. Goddess, I’m cynical.

Say what? I haven’t weighed 115lbs since I was 14 years old. I didn’t even grow proper breasts till I was 17! Where do these people get these totally arbitrary figures? 1970s diet books?

Seriously. I lost a bunch of weight in high school because of depression, and it was when I got down to 105 (I’m 5’1) that my mom started worrying I was starving myself and started buying all my favourite foods to tempt me to eat more. Because I looked just terrible. (And before anybody thinks I’m hating on skinny people, I’m sure 5’1 and 105 is a very healthy and attractive weight for some people but for a lot of us, me included, it’s unhealthily thin).

As an astrophysicist I’ve never heard of PNAS until today. So i guess that lets you know how highly we view it- it’s even lower on the totem pole than Science or Nature!

That said. . . . .I’ll worry about y’all cherry picking the day I see the studies aren’t hugely baised and stop ignoring the basic principles of selection for similar groups (research and control). I keep thinking that perhaps we need to send medical and public health people back to statistics to remind them why we do things like keep the median age of both samples the same to avoid adding error to the results.

“the author of this site recommends that the ideal rule of weight is that you allow 100 lbs for the first 5′ of height and 5 lbs for each additional inch.”

ah, the equation that added another brick to my wall of hell. i’m 5’5″ and have fluctuated between 130 and 145 during my adult life. 135 seems to be what my body seeks when i give it a rest, but for years i kept trying to get thinner because all i heard was 125 125 125 125 125 125 12555555555… and then i would shoot to 145 as soon as i hit 129 and burned out and started binge eating like crazy. it makes me very sad, because 135 is *so* not even close to being overweight. it’d be nice if humans could go back in time and give the younger versions of themselves a good slap-slap wake-up.

and re: sleep/work ethic. i believe it was in Sicko that there was a clip of GWB praising a middle aged woman at one of his town hall meeting deals because the woman worked three jobs. his response? “now that’s a real american!” i felt a terrifying surge of anger at that one.

and re: sleep/work ethic. i believe it was in Sicko that there was a clip of GWB praising a middle aged woman at one of his town hall meeting deals because the woman worked three jobs. his response? “now that’s a real american!” i felt a terrifying surge of anger at that one.

Lola: The French are not “much thinner than Americans.” People who live in expensive parts of France (e.g. Paris and the Riviera) tend to be quite thin, but that’s also true in America — you won’t see a lot of fat people in, say, Malibu or Scottsdale or most of Manhattan. Tourists do not tend to go to the poorer parts of France where fat people live, which reinforces the mythology that all Frenchpeople are thin. They certainly are not. Here’s more (warning: link is not especially fat friendly).

And although I don’t have numbers on what the current rates of smoking are now in France, I gather that they’ve been in decline for a while, and I would imagine that more and more people will be quitting with the new indoor smoking bans. That should put even more weight on Frenchpeople, albeit in a healthier way. (Currently their death rates from smoking-related illnesses dwarf Americans’.)

Meowser, thank you for answering, and for the link to the article. Let me just explain that I’m very new to the “fatosphere”, though I’ve privately been trying to deal with my own body acceptance for ages (I’ve been overweight since puberty, and I think this is the way my body is supposed to be). However, it’s hard for me to accept that, especially coming from a country (Brazil) I love with all my heart, but which is probably the country that puts more pressure in its women. I don’t know of any body acceptance movements in Brazil. Also, I should explain that my very new blog (I have been writing in another site and in a Brazilian newspaper for 10 years) is not exclusively about body acceptance. I’m a movie critic, so the main topic is cinema. But there I have a newfound freedom to post about any topic I want, and obviously I’ve been writing about topics that mean something to me. My readers are not women trying to accept their own bodies. I write for a more general public. And this very general public is not very welcoming of opinions such as “being fat is okay” or “health at any size” (concepts I agree with!). I have to go slowly if I want to help diminish the prejudice that exists against fat people. I think we should understand that it’s not easy for lay people to accept these concepts. They have been told over and over again that fat equals death, ugliness, never having a romantic relationship… They don’t even know scientific studies rebutting these assumptions exist. I’m not defending tolerance for bigots, but for people who are not haters of us fatties, and still lack information counterpointing everything they hear daily from the media. Imagine, if it’s hard for US to accept that it’s ok to be fat, it’s also hard for them! Having said that, it is a general, international assumption that Americans are one of the most obese countries in the world. I know that in Brazil the number of obsese and overweight people is increasing, and already reaching 30%. The article you suggested, Meowser, points out that Americans are fatter than the French:

” True, absolute rates are still lower here than in the United States and most other European countries: 11.3 percent of the French are obese and nearly 40 percent overweight, compared with more than 50 percent overweight in Britain and the United States.

But the sudden sharp rise – 5 percent annually since 1997 – is causing great alarm in a society renowned for thinness, a country that long seemed exempt from a worldwide epidemic of obesity. ”

I’m asking you because you have more experience with fat acceptance and with related scientific articles. How do I challenge, for example, the idea that obesity has been increasing all over the world? Don’t the numbers disrupt the assumption defended by fat acceptance movements that fatness is genetic? I mean, even if we discount the ridiculous BMI increase ten years ago from 25 to 27, isn’t the world as a whole still becoming more overweight? And can we claim that all, say, 30% of Brazilians who are now obese or overweight have a genetic disposition to be fat? Thank you for your willingness to help.

Lola, I think it helps to understand, instead of overall “obesity” figures, at least in the U.S., exactly who it is that has gained the weight. When you break things down by weight categories, what you’ll see is that over the past 20 years or so, the thinnest people have stayed the same or gotten thinner, people in the middle have gained an average of about 10 to 15 pounds, and — you guessed it — the people who were already quite fat have gained the most weight of all. This would reinforce, not refute, the idea that a tendency to be “obese” is genetic .

Also, there really has not been any change at all in the number of “obese” people in the last 5 years (some would say that statistically there hasn’t been any change in the last 10 years); that would seem to indicate there is a level at which weight gain does level off.

Anyone who has the linkies on these, please feel free to provide them. I’m working right now and don’t have time to search for them right this second.

There’s a large deposit of BAT on mammal’s backs, including rats and humans. It stretches across the upper back like a shawl. And it works like an electric blanket, producing warmth to heat the body, especially during sleep. It is very oxygen intensive to use, but it is “priviliged” in that oxygen is preferentially directed to it before other tissues, not unlike it is to the brain. When baby rats are in cold temperatures sleeping (and baby rats, like baby humans, sleep over 90% of the time) without littermates, their BAT goes wild and keeps them warm, but more and more oxygen goes to the BAT and less and less to other parts of the body, like the nervous system. Breathing becomes labored and even then there’s not always enough oxygen. Warm the rat up by putting it in its litter or raising the temperature and the oxygen balance resumes. This tissue is very active in human babies in the first months of life. It is possible, but not firmly established, that the Back To Sleep campaign might work because it insulates the BAT and makes it less oxygen-demanding because it has less work to do. Oxygen balance is normal and babies do not go into respiratory distress warming themselves. And their nervous systems remain normally oxygenated.

BAT continues to work throughout life but is vitally important in infants since they have limited mobility and can do less to warm themselves up. Also, neonates sleep so much that even when their mobility is better than that of human babies, they aren’t using it much.

The whole 97 degree club thing is interesting. I too run about 97-97.4. About three weeks ago, I got really sick (in a flu way) for the first time in several years. I was freezing and could not get warm no matter what I did, so I knew I had a fever. A few mornings later I woke up bathed in sweat, to where I knew the fever had broken, and I decided for some reason that that would be an interesting time to take my temperature. It was still 99. something, which is part of how I knew (other than feeling like absolute crap) that I was really sick, because at that point I felt 100 times better than I had the night before (so I assume the temp was even higher then). Normally my temperature is nowhere near 100 even when I know I have a fever.

I know this is not going to be 100% correlated with a low metabolism (actually I think my metabolism is comparatively high anyway… I have often bemoaned how I think I eat much more than many people here and feel guilty about it), and especially will not be the “answer” to why some people are fatter than others, any more than genetics or thyroid issues or environmental factors are. But those of you who do research in this area or are familiar with the literature, do you know of any studies looking at average body temperature in connection with weight? It would be interesting to know if there was any correlation.

On another note, hotsauce and Jae, I mentioned the other day that bank commercial that sentimentalizes the fact that an apparently middle-class dad has to work a paper route (starting before dawn, natch, so you know if this were a real person he’d barely be sleeping) to afford braces for his daughter. That is not as bad as the real-life example you describe, but I find it just so sickening and frustrating–in 2008, in the “greatest nation in the world”–that we are apparently totally OK with people having to work themselves into an early grave just to survive.

Re: low body temperature—-this can be a marker for hypothyroidism (low thyroid function), which can affect your health and general feelings of wellness in many ways. Now, just because you have a low avg body temp doesn’t mean that you conclusively have hypothyroidism…..but you might want to consider being tested.

When you are tested, ask for the TSH, free T3 and free T4. Don’t just accept that your results are “normal;” ask for specific numbers and the range that they used to determine “normal.” Then you get a better picture than just a black-n-white answer of “normal” or not.

Also, there is controversy in the medical world as to when to diagnose hypothyroidism. The reference range used to be something like 0.5 – 5.0 (diff labs may have slightly diff variations on this). Some endocrinologists have espoused lowering the range to 0.3 – 3.0; others reject that change. Now I am hearing that some advocate lowering the threshold for diagnosis even lower, to 2.5. Others still won’t diagnose until levels well in excess of 5.0 – 5.5 or more. So whether you are “normal” or not can vary a lot depending on which range they choose to use.

I think the question is, do you have symptoms of hypothyroidism? If so, a ‘borderline’ TSH plus those symptoms might make a trial of meds worthwhile. If you have no symptoms, then a borderline TSH might not mean much of anything.

My anecdotal observation is that many women with PCOS or similar presentations have this kind of “borderline” hypothyroidism and often DO benefit from treatment with meds, even though they may not meet the classic definitions of hypothyroidism in the past.

For me personally, this was true. For years I had signs of possible hypothyroidism, but my levels were “borderline” or “normal.” One endocrinologist I consulted told me I was just looking for an excuse for being fat. So I quit having those levels checked. Several years later, I heard about the low body temp thing, checked mine on a whim, and found it usually around 97. A friend recommended an MD who was also more “alternative” in his training, we found my TSH to be in that borderline range, and given my sysmptoms, we started a trial of meds to see how it affected me.

TOTAL change!! It was amazing how much better I felt with the thyroid meds. I didn’t lose weight (which I could care less about anyhow) but it was amazing how much better I felt on the meds. Now I notice that even a small change in my TSH can make a huge difference in how I feel, and I feel best with a TSH of about 1.0 – 1.5.

Not everyone with a low temp needs thyroid meds, but I do think it’s worth having the TSH etc. test done to be sure. Most docs will only do the TSH but it helps to have your T3 and T4 levels done too, because sometimes the TSH can be normal and the others abnormal or vice-versa. To get a real picture of what’s up, it helps to have all three tests.

I think that many “obese” folks have a borderline TSH and might benefit from treatment. If you are thinking about kids, become pregnant, or have had children in the past, it’s esp important to get it checked regularly, because pregnancy and post-partum thyroid issues are incredibly common and has the potential to affect both you and the child significantly.

This post should be recommended reading for all first-time readers of this blog… it’s just a great outline in general for the approach taken here, why it’s legitimate, and it explains how what you’re doing isn’t cherry-picking: it’s having basic standards for scientific rigor.